长COVID,也称为SARS-CoV-2感染(PASC)的急性后遗症,指一系列持续的症状和健康问题,持续到COVID-19的急性期。本章对发病机制进行了概述,危险因素,表现,主要发现,以及与长型COVID相关的诊断和治疗策略。讨论了关于长COVID发病机理的假设,包括各种因素,如持续的病毒库,有或没有疱疹病毒再激活的免疫失调(例如,爱泼斯坦-巴尔病毒和人类疱疹病毒),生态失调,由感染引发的自身免疫,内皮功能障碍,微血管血液凝固,和功能失调的脑干和/或迷走神经信号。本章还重点介绍了与长发COVID相关的危险因素及其在儿童中的发生。LongCOVID的主要发现,包括免疫失调,血管和组织损伤,神经和认知病理学,眼部症状,内分泌问题,肌痛性脑脊髓炎和慢性疲劳综合征,生殖系统参与,呼吸道和胃肠道症状,以及症状的时间顺序,彻底探索。最后,本章讨论了长COVID诊断和治疗方面的挑战和当前方法,强调需要多学科护理和个性化管理策略。
Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), refers to a constellation of persistent symptoms and health issues that continue beyond the acute phase of COVID-19. This chapter provides an overview of the pathogenesis, risk factors, manifestations, major findings, and diagnosis and treatment strategies associated with Long COVID. Hypotheses regarding the pathogenesis of Long COVID are discussed, encompassing various factors such as persistent viral reservoirs, immune dysregulation with or without reactivation of herpesviruses (e.g., Epstein-Barr Virus and human herpesvirus), dysbiosis, autoimmunity triggered by infection, endothelial dysfunction, microvessel blood clotting, and dysfunctional brainstem and/or vagal signaling. The chapter also highlights the risk factors associated with Long COVID and its occurrence in children. The major findings of Long COVID, including immune dysregulation, vessel and tissue damage, neurological and cognitive pathology, eye symptoms, endocrinal issues, myalgic encephalomyelitis and chronic fatigue syndrome, reproductive system involvement, respiratory and gastrointestinal symptoms, and the chronology of symptoms, are thoroughly explored. Lastly, the chapter discusses the challenges and current approaches in the diagnosis and treatment of Long COVID, emphasizing the need for multidisciplinary care and individualized management strategies.